In an ideal world, every nursing mother-baby pair would constantly remain in one another's presence, and no breastfed baby would ever need to take a bottle. I had the privilege of enjoying this ideal with my fifth baby, Mark, and I can attest to its many advantages and rewards. Unrestricted and exclusive breastfeeding gives a baby the guarantee of his mother's continual presence and the instant availability of optimal nourishment and nurturing. It gives a woman the best chance of having a continuous abundant supply of milk and of being able to nurse her baby a year or more. Whether by necessity or personal choice, however, the reality is that most breastfed babies in the United States do take bottles from time to time. In many cases, regular bottle-feedings of expressed milk or formula become necessary when nursing mothers daily are separated from their babies due to employment or schooling. Supplemental bottle-feedings are sometimes required for babies whose mothers produce insufficient milk.
Some parents choose to give a bottle occasionally because the father, grandmother, or other relative wants to share in feeding times. Other parents elect to familiarize their baby with bottle-feeding to allow the mother the option of leaving her infant with another caretaker. If you do plan to give your breastfed baby some bottle-feedings, the following guidelines should help minimize the risk of bottles interfering with successful breastfeeding:
Delay the introduction of bottles for at least three to four weeks. It is highly tempting at times to offer a bottle in the early weeks of breastfeeding to let a tired new mother get some badly needed rest. But early use of bottles before breastfeeding has become well established can undermine breastfeeding success. When a baby is first learning to nurse, he may find it easier to obtain milk from a bottle and, thus, develop a preference for bottle-feeding. Due to the close balance of breast milk supply and the infant's demand, it is important to nurse as often as your baby acts hungry. Displacing nursings with bottle-feedings can jeopardize the establishment of an abundant milk supply.
If you are considering giving a bottle in the early weeks of breastfeeding because your baby seems persistently hungry, promptly seek medical advice. When a baby is not obtaining sufficient milk the situation needs to be evaluated and remedied quickly. Feeding supplemental milk may be essential until the breastfeeding difficulties can be overcome. Never be afraid to give a bottle if your baby's welfare depends on it.
Put expressed breast milk in the bottle whenever possible. Feeding expressed breast milk is far preferable to giving supplemental bottles of formula. Infant formula provides inferior nutrition compared with human milk. Not only do formulas lack the immune benefits in human milk, but adding formula to a breastfed baby's diet actually decreases the protective effects that exclusive breastfeeding provides against infant illness. Babies readily can develop allergies to both cow's milk-based and soy formulas, especially when a parent or sibling has a history of food allergies. By feeding milk that has been expressed from your breasts, your baby will be receiving what your body has produced for her. When a breastfed baby drinks a bottle of formula that the mother's breasts didn't produce, the delicate balance of "breast milk supply and demand" can be upset.
Pump your breasts whenever you substitute a bottle-feeding for a nursing. Skipping a few nursings might seem convenient at first glance, but it can soon lead to diminished milk supply. If your breasts are not emptied at a regular feeding time, chemical inhibitors in the accumulated milk and unrelieved pressure in the breast provide a powerful message to your body to decrease milk production. Ideally, if your baby misses a nursing, you should use an effective breast pump or hand expression to empty your breasts in order to keep up your milk production. So you see, giving bottles really isn't very convenient after all.
When possible, offer a small amount of milk, instead of replacing an entire feeding. If you just want to keep your baby familiar with bottle-feeding in preparation for going back to work or in case of an unanticipated separation, you can do so without disrupting breastfeeding. Many women mistakenly assume that the bottle must replace an entire feeding. Instead, you can offer as little as a half ounce of expressed breast milk to reassure yourself that your baby will accept a bottle and can use it effectively. Most women have less milk later in the day. If your baby still seems hungry after an evening nursing, that might be a good time to let Daddy offer a little of your expressed milk in a bottle. You can easily capture some extra milk after the early morning nursings, when your supply is more plentiful. You can either use a pump during or after feeding your baby (the second breast usually has not been as well-drained) or simply place a clean cup under one breast while you nurse on the other. When your milk lets-down, the breast that isn't being nursed may spontaneously drip a half ounce or more. You should refrigerate all collected milk and use it within about forty-eight to seventy-two hours.